Dentistry and the Challenge of Noncommunicable Disease

Noncommunicable diseases pose major challenges to global health in many forms, including cardiovascular and chronic respiratory disorders, diabetes, obesity, dental caries, periodontitis, mucositis and many cancers. They are all non-contagious, chronic and very distressing conditions characterized by long latency periods leading to functional impairment or disability, and rarely are they completely cured. This is not the typical perspective that most dentists bring to treating oral diseases, which probably explains why caries and periodontitis remain highly prevalent and so difficult to prevent and manage.

This presentation will explain the common risks shared by these diseases and how prevention and management of risks occur both with individual biological and behavioural responses, and perhaps more effectively with the socio-economic and commercial influences on how people live. 

Learning Objectives

Understand noncommunicable diseases, their common risk factors, and their burden on society;

Explain how oral diseases share common risks with other noncommunicable diseases, and why they are particularly burdensome in old age;

Identify effective strategies in clinical practice and society to prevent and manage these diseases most effectively.

Michael I. MacEntee, LDSI, Dip. Prosth., PhD, FRCDC, FCAHS, FFDRCSI is Professor Emeritus of Prosthodontics and Dental Geriatrics at the University of British Columbia. He is a teacher, researcher and prosthodontist with a special interest in geriatrics and public health. He chaired the Division of Prosthodontics and Dental Geriatrics in the Faculty of Dentistry at UBC from 1981 to 2004, and became an emeritus professor in 2015. He has published five books, 26 book chapters, and 167 peer-reviewed articles on various subjects including dental geriatrics, inequity in oral healthcare, prosthodontics and oral implants, quality of life, informatics and education. He was associated editor of several professional and academic journals, and the Editor-in-Chief of Gerodontology from 2012 until March 2018.

Professor MacEntee is a past president of the Royal College of Dentists of Canada, the International College of Prosthodontists, and the Association of Prosthodontists of Canada. He received a Distinguished Scientist Award from the International Association for Dental Research, and a Killam Teaching Prize from his university. In 2015 he was elected a Fellow of the Canadian Academy of Health Sciences, and in 2023 he was honoured with an Ad Eundem Fellowship of the Faculty of Dentistry by the Royal College of Surgeons in Ireland.

I’m glad I did that: lessons learned during my first three years of oral medicine and pathology practice.

Please join me, a recent graduate and RCDC fellow, as I reflect on my first three years of clinical practice in oral medicine and pathology. Attendees will hear about the insights and experience gained from very memorable cases. I will review the challenges and surprises that stood out during my early career and the lessons that I learned from each one. Topics will include diagnosing and managing complex oral pathoses, navigating difficult conversations with patients, and collaborating with other healthcare professionals to provide comprehensive care. The presenter will also examine the emotional impact of complex cases and the significance of self-care in the face of adversity.

Learning objectives

To identify clinical pitfalls and common mimickers of lesions encountered in oral medicine and pathology practice, and the strategies for effectively detecting and treating them;

To discuss the importance of building strong relationships with colleagues and referral partners, and the role of interprofessional collaboration in providing comprehensive patient care;

To explore the emotional impact of challenging cases and the importance of self-care, resilience, and seeking support from peers and mentors in maintaining well-being.

Dr. Nathan Lee is a dual certified specialist in both Oral Medicine and Oral Pathology, as well as a Fellow of the Royal College of Dentists of Canada. He received his undergraduate DMD and specialty certificates from the University of British Columbia and now maintains private practice in Victoria, BC. Moreover, he holds appointments as a Staff Specialist with Vancouver Coastal Health, Division of Otolaryngology, Department of Surgery, and is a Clinical Assistant Professor at UBC, Faculty of Dentistry.

Interdisciplinary Management of Impacted Maxillary Incisors.

Impacted teeth pose an interesting challenge to the entire dental team. In this presentation, we will examine the prevalence, etiology, associated anomalies, and treatment modalities available in the management of impacted maxillary central incisors. The importance of a collaborative approach between the different disciplines in the planning and execution of a comprehensive treatment plan will be highlighted. The contribution of the many specialties involved – Orthodontics, Pediatric Dentistry, Periodontics, Prosthodontics and Oral Maxillofacial surgery will be reviewed. Each discipline provides essential knowledge and input in developing a comprehensive plan of care that addresses the patient’s immediate and long-term esthetic and functional needs.

Learning objectives

Impacted central incisors:

Recognize etiological factors, associated anomalies, and the importance of early detection.

Review treatment options and sequence of care.

Describe long-term periodontal and restorative considerations.

Dr. Liat Tzur Gadassi, DMD, MSc, FRCDC is a Clinical Associate Professor at the University of British Columbia. She completed her dental degree Cum Laude at the Hebrew University in Jerusalem, Israel, where she later pursued her Orthodontic specialty education.  Dr. Tzur Gadassi is a certified Canadian and Israeli specialist in orthodontics and dentofacial orthopaedics, currently practising in the lower mainland. She is an active member in the Canadian, American and Israeli Associations of Orthodontics as well as the Pacific Coast Society of Orthodontists. Dr. Tzur Gadassi has received numerous awards, including the UBC teaching award. Her teaching focuses on the clinical and interdisciplinary aspects of orthodontic care as well as Mixed Dentition and Early Treatment.

Head and Neck Resections and Prosthetic Rehabilitation.

An overview of head and neck prosthetic rehabilitation after surgical resection with and without surgical (microvascular) reconstruction. We will review anatomical challenges, different types of prostheses and treatment planning considerations. We will also discuss the use of digital technology to improve patient outcomes. 

Learning Objectives

Recognize anatomical challenges that present with maxillary and mandibular resections and reconstructions

Identify situations where an obturator prosthesis would be appropriate

Review the importance of the collaborative efforts of the multidisciplinary team

Dr. Angela Wong is a certified specialist in Prosthodontics with advanced fellowship training in Oral Oncology and Maxillofacial Prosthetics from the University of Texas MD Anderson Cancer Center. She was born and raised in Vancouver, BC where she attended the University of British Columbia (UBC) for her undergraduate sciences, general dentistry, general practice residency and prosthodontics training programs. Her master’s thesis explored gene expression of cells grown on different dental implant surfaces. 

Dr. Wong works full-time in clinical practice and serves as the Provincial Practice Leader in Prosthodontics at BC Cancer where she provides removable, fixed and implant prosthetic rehabilitation of head and neck cancer patients. She is also the course director of Graduate Maxillofacial Prosthodontics at UBC. Since 2018, she has been a board examiner in the specialty of Prosthodontics for the Royal College of Dentists of Canada (RCDC). She is the Dental Specialty Representative and board member of the BC Dental Association, as well as the current President (2023-2025) of the BC Society of Prosthodontists.

Implant reconstruction following oral cancer resection.

Cancer resection of the oral cavity presents complex anatomy for dental implantation, particularly following a continuity defect of the maxilla or mandible.

Implant reconstruction involving the transferred fibula or scapula flap remains the most routine way to help patient regain some oral function.

We discuss some of the anatomical challenges and complications and their management, focusing primarily on the peri-implant hard and soft tissue environment.

Learning objectives

Identify the anatomical differences between physiologic and post-free flap implant sites.

Multi-disciplinary approaches to maximize reconstruction outcome.

Future directions in research.

Dr. David Yang is the Provincial Practice Leader in Oral and Maxillofacial Surgery for BC Cancer.

He oversees oral surgical care for approximately 800 cancer patients yearly, many of whom present with unique oral issues associated with radiation, chemotherapy & tumour resection. 

He is involved in clinical research and is a co-author for the Oral Care Manual for the Cancer Patient.  He has a professional interest in jaw necrosis stemming from radiotherapy (ORN) or anti-resorptive medication such as bisphosphonates (MRONJ).